Associate Fee Schedule Specialist - Bill Review Department
Associate Fee Schedule Specialist - Bill Review Department
Company Overview
Managed Care Network, Inc. is a boutique workers’ compensation, auto, and disability managed care firm built on a simple premise: provide multi-disciplinary expertise for claims teams, promote our customers’ success and outcomes with a high-touch, high-quality business model. For over 30 years, Managed Care Network has delivered premium nurse case management, Prior Authorization Requests, Utilization Review, medical bill review, enhanced specialty bill review services, Smart Pharmacy oversight, and proprietary cost mitigation solutions to self-insured employers, carriers, and third-party administrators across New York State and beyond.
We are a small, high-performing team. Every role here matters. Every person contributes directly to outcomes.
Job Description
The Associate Fee Schedule Specialist plays a vital role in the medical bill review process by ensuring accurate intake, organization, and documentation of medical bills. This position supports compliance efforts and facilitates communication between internal teams and external partners, contributing to efficient and accurate claims processing. The ideal candidate will have experience in medical billing for Workers’ Compensation fee schedule and No-Fault insurance cases.
We are looking for a motivated individual who works well with others, acts professionally, and demonstrates excellent time management skills. This individual will also need excellent computer skills and have an eye for detail.
Qualifications
Attention to details and high level of accuracy with Quality Assurance experience.
Claims experience at an insurance company or third part administrator (preferred)
Minimum of 1 year of medical billing or bill review experience (preferred)
Familiarity with medical terminology, CPT, ICD-10, and HCPCS codes
Proficiency in Microsoft Office Suite (Excel, Outlook, Word, and Access)
Experience with bill review systems
Familiarity with NYS Workers’ Compensation and No-Fault billing practices (preferred)
Highly detail-oriented with strong organizational and accuracy skills
Ability to manage multiple tasks and meet deadlines in a fast-paced environment
Strong communication skills and ability to work both independently and collaboratively
Positive attitude, reliability, integrity and strong work ethic
Education & Experience
2 years of medical office experience (preferred)
Knowledge of medical terminology or willingness to learn
Associate’s degree in administration (preferred)
Job Duties and Responsibilities
Key Responsibilities
Provide administrative support to the Bill Review Department to ensure smooth daily operations
The ability quality review a medical bill upon to ensure the claim numbers are accurate, and other critical document.
Perform data entry with accuracy
Enter, update, and maintain accurate claim and billing data within the bill review platforms
Review a claims system to read claims data, authorization requests, and legal decisions, and enter notes and documents into a billing system
Be familiar with ICD-10 and CPT codes.
Perform case and claims reviews to ensure documentation supports billed services
Track, monitor, and prioritize progress, identifying urgent cases, balancing workloads, and ensuring timely completion of high priority items.
Process incoming and outgoing documentation, including emails, letters, faxes, and invoices, in accordance with client handling guidelines
Communicate effectively with adjusters, coders, and internal teams to resolve billing or documentation issues
Deliver exceptional customer service through professional and positive interactions
Communicate with adjusters, coders, and internal teams to resolve billing or documentation issues
Other Functions
Assist with projects and tasks assigned by leadership
Collaborate with team members across departments as needed
Help manage inventory, assign referrals, and ensure completed work is properly processed
Remain adaptable to changing priorities with a strong sense of urgency
Job Type Full-Time | Monday-Friday | 8:00 am - 4:30 pm
Salary $41,600.00 - $43,680.00 per year
Location: In person/On site – This is an onsite office position in Grand Island, NY with the ability to transition to hybrid/work from home (with mgmt. approval).
Benefits Offered
401(k) with 3% Match
Life insurance
Health insurance
Dental insurance
Vision insurance
Interested in Applying: Submit your resume and a brief cover letter to HR@managedcarenetwork.com
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